摘要
目的探讨艾滋病(AIDS)合并播散性马尔尼菲蓝状菌病(Talaromyces marneffei,TM)临床特征,提高对疾病的认识。方法回顾性分析2014年4月-2018年6月温州市中心医院收治的25例艾滋病合并马尔尼菲蓝状菌病患者的临床资料及相关实验室检查结果。结果患者主要以发热、贫血、咳嗽、消瘦、皮疹、脾肿大、多发淋巴结肿大等为临床特征;患者多合并感染;20例患者白细胞计数降低、21例患者血红蛋白水平降低;20例患者血培养马尔尼菲蓝状菌阳性,5例患者多部位取材标本培养阳性;25例患者胸部CT检查异常;16例患者采用以两性霉素B为主的方案治疗,9例使用伏立康唑注射液,23例好转出院。结论艾滋病合并播散性马尔尼菲蓝状菌病临床表现各异,多数病情进展迅速,尽可能的取材不同标本送检培养以明确诊断,减少漏诊、误诊,改善预后。
OBJECTIVE To explore the clinical and laboratory features of AIDS cases infected with disseminated Penicilliosis(Talaromyces) Marneffei. METHODS Twenty-five patients hospitalized between Apr. 2014 to Jun. 2018 were enrolled, of which the clinical and laboratory features were analyzed. RESULTS The most presented clinical symptoms and signs in descending order were fever, anemia, cough, emaciation, rash, splenomegaly, multiple enlarged lymph nodes and so on. Blood culture of all patients were found to be positive for P. Marneffei, 5 cases of which were cultured positive for multi-site samples. Twenty-five patients performed by chest CT examination were abnormal;16 patients were treated with amphotericin B;9 patients were treated by the injection of voriconazole;23 patients were improved and discharged. CONCLUSION The symptoms of AIDS patients complicated with disseminated P. Marneffei have various clinical manifestations;The progress of the disease in most cases progress quickly, so it is necessary to diagnose definitely from different specimens in order to reduce the rate of missed diagnosis and misdiagnosis and improve the prognosis.
作者
施伎蝉
蒋贤高
刘赛朵
崔小亚
宁洪叶
叶新春
吴祥兵
吴正兴
SHI Ji-chan;JIANG Xian-gao;LIU Sai-duo;CUI Xiao-ya;NING Hong-ye;YE Xin-chun;WU Xiang-bing;WU Zheng-xing(Wenzhou Central Hospital,Wenzhou,Zhejiang 325000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第24期3706-3709,3714,共5页
Chinese Journal of Nosocomiology
基金
温州市科技局基金资助项目(Y20180777)
关键词
获得性免疫缺陷综合征
马尔尼菲蓝状菌病
临床特征
Acquired immunodeficiency syndrome
Talaromycesis marneffei infection
Clinical features
